Follow-up strategy after curative resection of gastric cancer: a nationwide survey in Korea.

BACKGROUND: To date, guidelines for follow-up after curative resection in patients with gastric cancer have not been reported. Thus, most centers have managed the process according to institution-specific protocols. We investigated current follow-up practices after curative resection of gastric cancer using a nationwide survey in Korea, where gastric cancer is epidemic.
METHODS: From July to September 2007, questionnaires were sent out to 205 members of the Korean Gastric Cancer Association (KGCA). The questionnaire packet contained a covering letter, general information, and a questionnaire about follow-up schedules and methodologies.
RESULTS: Forty-six percent (96/205) of the members of the KGCA returned the survey. The majority of responders indicated that patients with early gastric cancer were followed up every 6 months (64.4%) for the first year, every 12 months (47.9%) for the next 4 years, and every 12 months (68.8%) from the fifth year after surgery on. For patients with advanced gastric cancer, follow-up studies were carried out every 3 months (43.8%) for the first year, every 6 months for the next 4 years, and every 12 months (75.0%) from the fifth year onward. After surgery, most responders used computed tomography for imaging, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 as tumor markers, and serum iron among follow-up measures.
CONCLUSIONS: Clinicians have a variety of approaches regarding the extent of follow-up and methodologies used after curative resection for gastric cancer. Therefore, a multicenter randomized trial will be needed to compare routine follow-up with intensive schedules. Our results could facilitate the design of such studies.